Bell v. New York Life Ins. Co., No. 19556

• Docket Nº: No. 1
• Citation: 134 Ind.App. 614, 190 N.E.2d 432
• Case Date: May 22, 1963
• Court: Court of Appeals of Indiana

Page 432

190 N.E.2d 432 134 Ind.App. 614 Willis D. BELL and James F. Bell, Appellants,
v.
NEW YORK LIFE INSURANCE COMPANY, Appellee. No. 19556. Appellate Court of Indiana, Division No. 1. May 22, 1963.

[134 Ind.App. 615] Lewis E. Jones, Anderson, for appellants.

Robert L. Austin, Anderson, for appellee.

CARSON, Judge.

This is an appeal by the plaintiffs below, Willis D. Bell and James F. Bell, growing out of an action on a group insurance policy for life insurance benefit and hospitalization and sickness benefits. The policy was issued by the New York Life Insurance

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Co. [134 Ind.App. 616] to the Gary Goodwill Industries, Inc., the employer of the appellants' decedent.

To the plaintiffs' amended complaint the defendant, appellee herein, addressed a demurrer on two grounds: 1. Insufficient facts to constitute a cause of action for either life insurance benefits or hospital or surgical, and 2. A defect of parties defendant. This demurrer raised issues of law which were determined by the court.

The court sustained the defendant's demurrer as to the life insurance benefits and as to the hospital and surgical benefits and ruled that the appellants, plaintiffs below, plead further by April 21, 1960. There was no ruling on the question of a defect of parties defendant and no question is presented to this court on appeal on that issue.

On the 18th of July, 1960, the plaintiffs having failed and refused to plead further, the court defaulted them and rendered judgment accordingly against the plaintiffs and for the defendant.

From this ruling and judgment the appellants assigned that there was manifest error in the judgment and proceedings in this cause, which is prejudicial to the appellant in this: The court erred in sustaining the appellee's demurrer to the appellants' amended complaint.

For us to dispose of the question presented by this appeal, it is necessary for us to consider the language of the insurance certificate furnished to the appellant decedent, and particularly those portions upon which the present action was predicated. We find the following language in the certificate:

'IMPORTANT NOTICE

'If you cease active full-time work for any reason, contact your Employer at once to determine [134 Ind.App. 617] what arrangement, if any can be made to continue your insurance.

'The Group Policy is a contract between the Employer and New York Life, and provides that it may be changed or terminated by written agreement between those parties. This certificate is a summary of the provisions of the Group Policy affecting you, and is merely evidence of the insurance provided under the Group Policy.

* * *

* * *

'TERMINATION OF YOUR INSURANCE

'The Group Policy provides that, except as provided in the Continuance of insurance provisions, your insurance will terminate upon the occurrence of the first of the following events:

'1. termination of your employment, i. e. cessation of active full-time work for the Employer, in the classes of employees eligible for insurance; or

* * *

* * *

'LIFE INSURANCE PROVISIONS DEATH BENEFIT

'The Group Policy provides that, if you die while insured by its Life Insurance provisions, New York Life will pay your beneficiary the amount of Life Insurance applicable to you (shown in the Schedule of Insurance), upon receipt of due proof of death.

'CONTINUANCE OF INSURANCE

'The Group Policy provides in its Continuance of Insurance provision, that, notwithstanding its other provisions, your insurance will remain in force after the day it would otherwise terminate, as follows:

'31-Day Benefit: It will remain in force during the thirty-one days in which you are eligible to exercise the Conversion Privilege, whether or not you have applied for conversion, in

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an [134 Ind.App. 618] amount equal to the maximum amount you are eligible to convert.

* * *

* * *

'CONVERSION PRIVILEGE

'The Group Policy provides that if your insurance terminates because of (a) termination of employment, or (b) termination of membership in a class eligible for insurance, you shall have the privilege of converting all or at your option any part of your insurance to an individual policy of life insurance, without being required to furnish evidence of insurability, subject to the following conditions:

'1. written application for the policy and payment of the first premium thereon must be made within thirty-one days after termination of such employment or membership; * * *.'

This being an action based upon the insurance policy, we must examine the complaint, to which demurrer was filed, to determine if the appellants alleged a cause of action within the terms of the insurance policy. The pertinent portions of the complaint which...